Anti-Inflammatory Meds and Muscle Growth

NOTE: This was originally written for Oxygen Mag digital version.

There has been a heated debate over many years within the bodybuilding community about whether anti-inflammatory medications like ibuprofen (Advil, Motrin) and naproxen sodium hinder muscle growth. These medications inhibit the synthesis of prostaglandins, which also play a role in muscle synthesis. All it took was one clinical study published in the Journal of Clinical Endocrinology and Metabolism to put bodybuilders into a panic about reduced protein synthesis, and it didn’t matter that such results were found in laboratory rats. While there is some evidence to suggest that the anabolic signal is shut off when anti-inflammatories circulate in the bloodstream, nothing is absolutely conclusive, and what might be seen in the rat model might not necessarily be the case for humans.

While I will never advocate chronic use of painkillers and anti-inflammatory agents, I think they definitely serve a purpose when acute injury is present. When I find myself in the middle of disputes with bodybuilders who INSIST that a few days on such medications will completely destroy all their efforts in the gym, I simply shake my head in frustration. If you are injured and your lifting is adversely affected by the injury, whether it be a muscle strain, a ligament tear, or a minor disc herniation, you need to be aware that training through that injury, especially when it deranges your form and causes other body parts to compensate for the injury, will end up really messing you up over time. I honestly think that a minimal decrease in muscle mass over the course of a few days is preferable to the imbalance and asymmetry which usually occur when a bodybuilder foolishly pushes through heavy workouts despite an injury which has a domino effect on the body.

Common sense, and medical expertise, dictate that the inflammation must be removed from the area, most commonly through short term administration of anti-inflammatory agents, ice, and rest. Trust me, if you follow a regimen like this, you won’t lose all the muscle you have built over the years. Be sure to take these medications with food, and if you have any history of gastric ulcers. bleeding disorders, or kidney dysfunction, avoid taking them.

Remember that I am talking about DAYS, not weeks or months. This is one time when eating constantly has its benefits, since bodybuilders and fitness people can pretty easily fit in their medication administration with one of their meals. I know it’s difficult to back off from training, but if you truly want to HEAL, you must give the injured area time to repair itself. If you insist on continuing to train through the injury, especially, without any medications or other interventions on board, you can count on the injury either lingering or worsening over time.

Leaky Gut

food-allergy-leaky-gut-inflammation
If you suffer from sudden food sensitivities, aching joints, digestive upset, fatigue or weight gain, you may be suffering from leaky gut, which is also referred to as increased intestinal permeability. Leaky gut is characterized by the opening of pores in the small intestine, resulting in undigested food particles, bacteria, and toxins traveling to the bloodstream. The presence of these substances in the bloodstream triggers an immune response, whereby the body builds antibodies to the foreign substances but also attacks itself, creating food allergies and autoimmune disorders.

You are probably wondering how something like this occurs and if you are at risk. Let’s look at the main causative factors leading to leaky gut syndrome:

1. Chronic constipation – If you are usually constipated, toxins will often build up in stool, irritating the intestinal lining and causing inflammation, which then causes the pores in the small intestine to expand. In severe cases, Crohn’s Disease, irritable bowel syndrome,or colitis can occur.

2. Chronic stress – The immune system really takes a beating when subjected to chronic stress. If the immune response is compromised, pathogenic bacteria can cause widespread inflammation in the intestines, and leaky gut is a common result.

3. Dysbiosis – This is an imbalance between beneficial and harmful bacteria which can result from antibiotics or poor diet. Inflammation develops, causing the pores to widen.

4. Toxins – We are exposed to many thousands of toxins, but the worst offenders are found in our water supply, pesticides, and in certain medications.

leaky-gut
What Is The Solution If You Have A Leaky Gut?

I have several dietary recommendations for treating a leaky gut.

1. Glutamine – I am already a big fan of glutamine in general, but especially for those who suffer from leaky gut. This amino acid has specific activity in the intestine, and restores healthy soft tissue in the region. Over time, regular supplementation with glutamine has a protective effect against intestinal disease. I tend to be fairly aggressive with glutamine and recommend 6 to 8 grams per day, or more if you engage in frequent exercise.

2. Fish oil – Try to find a formula which contains primarily omega-3 fatty acids. You can also increase your consumption of salmon.

3. Digestive enzymes – Digestive enzymes will aid in the breakdown of food substances, especially in older individuals and those suffering from leaky gut. Try taking them with every meal.

4. Betaine hydrochloric acid – Some people produce insufficient amounts of hydrochloric acid, which is needed to break down food in the stomach. If that is the case, betaine hydrochloric acid optimizes the process.

5. probiotics – Most individuals will benefit from adding probiotics into their daily regimen. Make sure to take at least 25 billion units per day for optimal gut health.

Ibuprofen Has Its Merits

ibuprofenOver the years, numerous medical studies have explored the idea that ibuprofen interferes with muscle growth, with conflicting conclusions. I know that there are some weightlifters who will take ibuprofen on a daily basis to combat numerous pain issues so that they can lift more comfortably, but this is something I would NEVER recommend. As a physician I am well aware of ibuprofen’s remarkable ability to shut down acute inflammation, but I am also aware of the risks of taking high dose ibuprofen over an extended period of time. I think it is also important to bear in mind that 1) there are different types of inflammation found in the body, and 2) some inflammation is actually necessary for optimal muscle growth.

The reason why I broach this subject is that I also know people who lift who stubbornly refuse to take ibuprofen under ANY circumstances, stating that it isn’t worth the impaired muscle growth. These people could be in agony from a muscle strain, bursitis, arthritis flare-up, tennis elbow or any number of conditions which arise from localized inflammation, yet will refuse to take anything. I will see them at the gym, struggling to move the weight that they are accustomed to lifting, only to cut their lifting regimen short or sharply reduce the weight lifted. Some of these people are so intent on pushing through the pain that they often make things WORSE and have to stop training completely until their injuries subside. Now that is just stupid. It makes far more sense to tackle the acute inflammation systemically with ibuprofen and rest the area for a few days so that one can return to full capacity, rather than risk even greater injury which essentially forces one to stop training.

I have recently dealt with a mild ankle sprain which I aggressively treated with ice, elevation, compression and high-dose ibuprofen for four days. Instead of being stubborn and refusing to take anything, I took 600-800 milligrams of ibuprofen twice a day with food, and also avoided any activities which required me to push off from my feet. I also refrained from doing any high impact moves which would aggravate my ankle. Was I concerned about adversely affecting my body’s ability to build muscle? Certainly not. Healing was my primary concern. Besides, there would have been no way that I could have trained the way I normally do while dealing with such outright pain, so it made sense to shut down the inflammatory process which was causing all the discomfort in the first place by taking the dreaded ibuprofen. I was smart about how I took it, and I did not take it for an extended period of time. Thankfully, it was a successful therapeutic treatment and I am glad I did it.

With all this said, I am still very cautious about prescribing high dose ibuprofen. The effects on the gastrointestinal tract are significant, so it is imperative to eat when taking this medication. I also caution people against taking too many doses throughout the day. A very real example occurred with a friend who was apparently taking high doses of ibuprofen (600-800 mg 4 times per day) without food for severe daily headaches. This practice resulted in a peptic ulcer which bled enough to cause her to pass out twice, landing her in the emergency room.

For those of you on the other side of the coin who have a habit of taking ibuprofen chronically, even if you are only taking 200 or 400 mg at a time, I highly recommend that you discontinue such chronic use. It is best to reserve ibuprofen for acute flare-ups.

Do Anti-Inflammatory Medications Hinder Muscle Growth?

stupidest

There has been a heated debate over many years within the bodybuilding community about whether anti-inflammatory medications like ibuprofen (Advil, Motrin) and naproxen sodium hinder muscle growth. These medications inhibit the synthesis of prostaglandins, which also play a role in muscle synthesis. All it took was one clinical study published in the Journal of Clinical Endocrinology and Metabolism to put bodybuilders into a panic about reduced protein synthesis, and it didn’t matter that such results were found in laboratory rats. While there is some evidence to suggest that the anabolic signal is shut off when anti-inflammatories circulate in the bloodstream, nothing is absolutely conclusive, and what might be seen in the rat model might not necessarily be the case for humans.

While I will never advocate chronic use of painkillers and anti-inflammatory agents, I think they definitely serve a purpose when acute injury is present. When I find myself in the middle of disputes with bodybuilders who INSIST that a few days on such medications will completely destroy all their efforts in the gym, I simply shake my head in frustration. If you are injured and your lifting is adversely affected by the injury, whether it be a muscle strain, a ligament tear, or a minor disc herniation, you need to be aware that training through that injury, especially when it deranges your form and causes other body parts to compensate for the injury, will end up really messing you up over time. I honestly think that a minimal decrease in muscle mass over the course of a few days is preferable to the imbalance and asymmetry which usually occur when a bodybuilder foolishly pushes through heavy workouts despite an injury which has a domino effect on the body.

Common sense, and medical expertise, dictate that the inflammation must be removed from the area, most commonly through short term administration of anti-inflammatory agents, ice, and rest. Trust me, if you follow a regimen like this, you won’t lose all the muscle you have built over the years. Be sure to take these medications with food, and if you have any history of gastric ulcers. bleeding disorders, or kidney dysfunction, avoid taking them. Remember that I am talking about DAYS, not weeks or months. This is one time when eating constantly has its benefits, since bodybuilders and fitness people can pretty easily fit in their medication administration with one of their meals. I know it’s difficult to back off from training, but if you truly want to HEAL, you must give the injured area time to repair itself. If you insist on continuing to train through the injury, especially, without any medications or other interventions on board, you can count on the injury either lingering or worsening over time.

emptystomach

Leaky Gut

food-allergy-leaky-gut-inflammation
If you suffer from sudden food sensitivities, aching joints, digestive upset, fatigue or weight gain, you may be suffering from leaky gut, which is also referred to as increased intestinal permeability. Leaky gut is characterized by the opening of pores in the small intestine, resulting in undigested food particles, bacteria, and toxins traveling to the bloodstream. The presence of these substances in the bloodstream triggers an immune response, whereby the body builds antibodies to the foreign substances but also attacks itself, creating food allergies and autoimmune disorders.

You are probably wondering how something like this occurs and if you are at risk. Let’s look at the main causative factors leading to leaky gut syndrome:

1. Chronic constipation – If you are usually constipated, toxins will often build up in stool, irritating the intestinal lining and causing inflammation, which then causes the pores in the small intestine to expand. In severe cases, Crohn’s Disease, irritable bowel syndrome,or colitis can occur.

2. Chronic stress – The immune system really takes a beating when subjected to chronic stress. If the immune response is compromised, pathogenic bacteria can cause widespread inflammation in the intestines, and leaky gut is a common result.

3. Dysbiosis – This is an imbalance between beneficial and harmful bacteria which can result from antibiotics or poor diet. Inflammation develops, causing the pores to widen.

4. Toxins – We are exposed to many thousands of toxins, but the worst offenders are found in our water supply, pesticides, and in certain medications.

leaky-gut
What Is The Solution If You Have A Leaky Gut?

I have several dietary recommendations for treating a leaky gut.

1. Glutamine – I am already a big fan of glutamine in general, but especially for those who suffer from leaky gut. This amino acid has specific activity in the intestine, and restores healthy soft tissue in the region. Over time, regular supplementation with glutamine has a protective effect against intestinal disease. I tend to be fairly aggressive with glutamine and recommend 6 to 8 grams per day, or more if you engage in frequent exercise.

2. Fish oil – Try to find a formula which contains primarily omega-3 fatty acids. You can also increase your consumption of salmon.

3. Digestive enzymes – Digestive enzymes will aid in the breakdown of food substances, especially in older individuals and those suffering from leaky gut. Try taking them with every meal.

4. Betaine hydrochloric acid – Some people produce insufficient amounts of hydrochloric acid, which is needed to break down food in the stomach. If that is the case, betaine hydrochloric acid optimizes the process.

5. probiotics – Most individuals will benefit from adding probiotics into their daily regimen. Make sure to take at least 25 billion units per day for optimal gut health.

In Defense Of Ibuprofen

ibuprofenOver the years, numerous medical studies have explored the idea that ibuprofen interferes with muscle growth, with conflicting conclusions. I know that there are some weightlifters who will take ibuprofen on a daily basis to combat numerous pain issues so that they can lift more comfortably, but this is something I would NEVER recommend. As a physician I am well aware of ibuprofen’s remarkable ability to shut down acute inflammation, but I am also aware of the risks of taking high dose ibuprofen over an extended period of time. I think it is also important to bear in mind that 1) there are different types of inflammation found in the body, and 2) some inflammation is actually necessary for optimal muscle growth.

The reason why I broach this subject is that I also know people who lift who stubbornly refuse to take ibuprofen under ANY circumstances, stating that it isn’t worth the impaired muscle growth. These people could be in agony from a muscle strain, bursitis, arthritis flare-up, tennis elbow or any number of conditions which arise from localized inflammation, yet will refuse to take anything. I will see them at the gym, struggling to move the weight that they are accustomed to lifting, only to cut their lifting regimen short or sharply reduce the weight lifted. Some of these people are so intent on pushing through the pain that they often make things WORSE and have to stop training completely until their injuries subside. Now that is just stupid. It makes far more sense to tackle the acute inflammation systemically with ibuprofen and rest the area for a few days so that one can return to full capacity, rather than risk even greater injury which essentially forces one to stop training.

I recently dealt with a bone spur which asserted itself with such exquisite pain that I was unable to bear weight fully on my left foot for 4 days. Instead of being stubborn and refusing to take anything, I took 800 milligrams of ibuprofen twice a day with food for a week. I also refrained from doing any high impact moves which would aggravate my foot and wore flat shoes for a week. Within the first 2 hours of taking the first dose of ibuprofen, I went from feeling like I was stepping on a knife to walking with only a slight limp. Was I concerned about adversely affecting my body’s ability to build muscle? Certainly not. Healing was my primary concern. Besides, there would have been no way that I could have trained the way I normally do while dealing with such outright pain, so it made sense to shut down the inflammatory process which was causing all the discomfort in the first place by taking the dreaded ibuprofen. I was smart about how I took it, and I did not take it for an extended period of time. Thankfully, it was a successful therapeutic treatment and I am glad I did it.

With all this said, I am still very cautious about prescribing high dose ibuprofen. The effects on the gastrointestinal tract are significant, so it is imperative to eat when taking this medication. I also caution people against taking too many doses throughout the day. A very real example occurred with a friend who was apparently taking high doses of ibuprofen (600-800 mg 4 times per day) without food for severe daily headaches. This practice resulted in a peptic ulcer which bled enough to cause her to pass out twice, landing her in the emergency room.

For those of you who have a habit of taking ibuprofen chronically, even if you are only taking 200 or 400 mg at a time, I highly recommend that you discontinue such chronic use. It is best to reserve ibuprofen for acute flare-ups.