Hey, everybody.
I'm Dr. Keller and welcome back.
Today, we're talking about a typical pill
that a lot of you might take
with some frequency,
maybe even took one today.
It's something that people take
sometimes for headaches,
sometimes you take it for a back spasm
or for some cramps,
women sometimes take it on their period
and this class of medications,
these pills are over-the-counter
so they're widely available.
The question we're addressing today is
just because they're over-the-counter,
does it mean that they're safe
and what should I be considering
when I take these pills?
So, anybody have an idea
what I'm talking about?
Yeah?
NSAIDs.
Or, NSAIDs.
I say NSAIDs, you say NSAIDs,
whatever you want.
NSAIDs, yes, it's an acronym.
I'm going to talk about
what it means in a bit
but, basically, if you're not familiar
with this term,
then, you certainly familiar
with some of the brands
like Advil, Motrin, Aleve,
these are other brands
and you can find them
at the pharmacy.
Ibuprofen is the chemical name,
there are others, naproxen is one.
And, again, they're over-the-counter,
they're available.
Usually, the pill is 200 milligrams.
Sometimes you can get them extra strength
prescribed to you up to 800 milligrams.
And, sometimes,
people just kind of take them,
not like candy but without much thought
about what they are
and what they could be doing to your body.
So, I'm going to get
into that a little bit
and you guys can decide if you feel
like NSAIDs are a good thing for you.
So, NSAIDs, the term stands for
non-steroidal anti-inflammatory drug,
okay.
It's a big, long, fancy word but basically
these evolved as alternatives to steroids.
That's why they're called
the non-steroids.
So, what's a steroid?
Well, a steroid, you might be thinking,
"Oh, it's like testosterone.
It's that stuff you give
yourself at the gym
so you can pump more weight."
That is one class of steroid
but in this particular case,
we're talking about a different class.
Those are called anabolic steroids.
We're talking about the corticosteroids.
And, corticosteroids are things like
cortisone, hydrocortisone,
that might be a cream
that you've seen at the at the pharmacy
that you can put on a rash.
Or, maybe at some point,
you've heard of prednisone
or been even prescribed prednisone.
Those are powerful anti-inflammatories
and they have been used
and they've been around for a long time.
But, the reason that we started looking
for alternatives is because
steroids have a lot of side effects.
They can lead to weight gain,
they're terrible for your bones,
they wreak havoc on your adrenal access.
So, they came up with this class
of non-steroidal drugs
to help with the inflammation issue.
Most of the time, people
 are taking them as anti-inflammatories.
So, why are these anti-inflammatories?
Basically, there's an enzymatic
process in your body
that is called the Cox process.
I'm going to make sure
that you see the spelling
so there's no misunderstandings.
So, the Cox process.
These anti-inflammatories
are what we call Cox inhibitors.
And so, they can block this portion
of the inflammatory cascade
so they can kind of keep
the white blood cells
from kind of releasing all their cytokines
and leading to the swelling
and the redness and the pain
that's associated with an injury, okay.
The problem is that, Cox,
as an enzymatic process,
has a couple arms to it.
And, there's COX-1
and there's COX-2, okay?
So, COX-2 is really
what we're targeting
and that's the part of
the inflammatory cascade
that kind of leads to the swelling
and the pain and all the issues.
The thing that we want to control
so that we feel better.
But, COX-1 is a viable process
that really has a lot of positives to it.
It helps heal, it produces
special chemicals
that are important for our body.
One of them predominantly
is the substance that helps
protect the lining of the stomach.
So, if you take something like Advil
that will block this,
then, guess what?
We're kind of putting an X
through this whole thing
and now, we've blocked,
not only the bad inflammatory stuff,
but some of that good stuff
that we wanted.
So, what happens?
Well, I mentioned,
the stomach as an issue.
So, let's go straight there.
You may have heard that
if you take a bunch of ibuprofen,
it can irritate your stomach.
Well, that is true.
Actually, what's happening is
it is blocking the production
of some of the natural chemicals
that are meant to protect your stomach
and if you do that too much,
you can actually irritate the stomach
and in worse conditions,
you can actually get an ulcer
that can lead to a very serious condition
where you could actually bleed
from that stomach ulcer
and your stomach, keep in mind,
is a very acidic environment.
So, it's churning out hydrochloric acid.
That's a crazy, crazy acidic acid
that we used to digest food.
But, our stomach is good
at protecting itself against that.
If we block the natural protection,
then, the acid can start
eating away at our stomach.
And then, you end up with something
called gastritis.
You've probably heard of gastritis.
It's just a fancy name
for inflammation of the stomach
and it can be actually quite serious.
So, some of the symptoms of gastritis
start with maybe a dull ache,
usually what we call substernal
like going on right in here.
It sometimes can increase to a burn,
sometimes it can get really bad
and feel like it's gnawing
right through you.
You might feel like
you want to eat something to calm it down
but then you do and
it feels worse
or it just feels better just
for a little bit of time
and you might feel like
you're getting a gassy feeling,
you're bloating,
you're burping a lot.
All these can be symptoms of gastritis.
Sometimes, it can get more serious
and you can start developing an ulcer
and some of the more serious symptoms
could be nausea, vomiting
and especially if you ever vomit up blood
or you ever notice
your stool has become dark and tarry,
you know, gross to think about
but in medicine,
we got to think about the other end.
If your stool is gross and tarry,
what in medicine we call melena,
it means that there's blood
that's come out of your stomach
and then, been digested along the way,
it gets this kind of like, almost like
molasses black consistency.
So, if you ever see those
or ever feel those,
you need to seek medical attention
right away
because you can bleed out
from a stomach ulcer
and actually die from it.
So, we've talked a little bit
about gastritis
but there are other things
that taking an NSAID can affect
and I just want to go over them.
You, guys, should know.
Number one,
they can affect your heart.
And, they have done studies where,
especially people who are prone
to heart issues,
can get what's called
congestive heart failure.
And, that means that your heart
gets weakened
and can't keep up with the blood
and you start to, basically,
build up fluid in your body,
you can notice it in your legs,
you can notice it in your lungs
by becoming short of breath
and they've seen, actually,
a 20%
increase in this thing
that I'm calling CHF,
congestive heart failure.
It's a 20% risk in patients
who are susceptible to it
just from taking something as "harmless"
as ibuprofen or Advil.
So, these are serious things.
Also, heart attacks,
we all know what that is.
You definitely don't want one.
It has been shown
that your risk of a heart attack
skyrockets up after taking ibuprofen.
Not just that day
but for like the full week after it.
So, these protective things
that are made in this Cox reaction
that we are blocking,
they're really necessary for our bodies
and if we stop them,
we're putting ourselves at risk.
Another thing is kidneys.
You can actually damage your kidneys
if you take too much of something
like an NSAID
or if you take it too frequently.
So, yeah, I know.
I'm ruining your day
because you have a headache
or you've got a muscle tear and--
"Gosh, now my doctor dude on Facebook
is telling me I can't even take Advil,
what I thought was
the most harmless of the things out there.
What am I going to do?"
Well, I'm going to give you
some alternatives.
Of course, in medicine,
it's always about weighing
risks and benefits
and there may come a time where,
really, yeah, you've got to take something
like a steroid or ibuprofen
because it's just--
something else isn't going to work.
But, keep in mind, that you got to
weigh those risks and benefits.
So, let's look at some alternatives
because, maybe,
they will do the trick for you.
The first thing is since really
this is all about reducing inflammation,
try to find other ways
to reduce inflammation.
One amazing way to do that
is dietarily.
So, try to have a diet
that's low inflammatory
or low in inflammation.
That could mean cutting out dairy,
that could mean cutting out gluten.
You can also do these antibody tests
like almost like food allergy tests
that can show you certain foods
that might be bad for your body
and your system, in particular.
That could also mean avoiding alcohol
which can cause a lot of
inflammation in the body.
And so, keep those things in mind
and try to eat a healthy diet without--
if you opt for organic foods,
hey, now you're avoiding the pesticides
and some of the hormones,
some of the other chemicals
that can also be very inflammatory
to your body.
That's one thing.
Number two, if you do have to take
something like an NSAID,
try to protect your stomach
and that can mean, basically,
avoiding other things
that irritate the stomach.
Caffeine is a big one.
Nicotine and cigarettes,
terrible for your stomach, okay.
Alcohol, again, very bad for your stomach,
very irritating.
So, if you find that you're taking them,
really, try to reduce the risk
by avoiding things like coffee,
at the same time,
at least an alcohol
and cigarettes.
And then, we get into some of
the natural anti-inflammatory things
and that's what I want to show you.
This is where it gets
a little more exciting.
So, we've got curcumin.
This is one brand,
this is a great brand, Curcumin.
And, curcumin
is a naturally occurring chemical.
It's what's found in turmeric.
Turmeric is a natural spice,
it's got that yellow color.
But, actually, curcumin,
when you concentrate it out,
you're getting a much higher
concentration than regular turmeric.
It's been shown to be
a powerful natural anti-inflammatory.
And, there's some other things
we can have.
Oh, ginger, a nice root.
Ginger is anti-inflammatory.
You can have it in tea,
you can add it to your food.
That's two great ways to have ginger.
And then, good old garlic.
Yeah, make sure--breath smell bad,
it comes out your pores
but garlic is a very powerful
anti-inflammatory.
So, yeah, you've got to weigh
the risks and benefits
but you might have to deal
with a little bit of bad breath
or a little bit that garlic smell
if you want to avoid
things like heart failure
or heart attack or a hole in your stomach.
Weigh the odds but I think
we really think about it,
you'll know what feels more important.
And then, there are other things
that you can do.
The other things you can take MSM,
a nice anti-inflammatory.
And then, if you've tried
with natural anti-inflammatories--
oh, and there are combos
like Whole Foods or vitamin shops
will make things called Cox inhibitors.
So, they're literally like
the natural compilation of things
that handle that enzymatic process
that we talked about,
that same kind of target.
But, they're going to give you
the good blockage
and not block those other things that you
want to salvage and save and protect.
And then, a lot of the other options
might have to do
with what you're trying
to treat underneath.
So, if it's a headache,
for example,
and you're taking ibuprofen
all the time for a headache,
talk to your doctor about
other alternatives  just for headaches.
It could be that you've got
tension headaches
and I have everything to do
with your posture,
I'm going to do a video series on that.
It could have to do with your eyes
and your eyesight,
it could be that you're getting migraines
and you could be on a migraine medication
or another migraine treatment
instead of the anti-inflammatories.
So, think about that.
If it's a musculoskeletal thing,
talk to your doctor,
"Is there another treatment
you could do for that?"
Physical therapy to really work
on that particular joint.
Other injection therapies for that joint
that could include
Prolotherapy or platelet-rich plasma
or some of the biological injections
that are out there that could help.
So, think good and hard
about what the particular issue is
and instead of just reaching reflexively
for that Aleve or that ibuprofen,
just keep in mind,
even though they're over-the-counter,
there are serious side effects with them.
When you're informed,
you make better decisions
and, at least,
if you run across something,
you know what you're
getting into.
Okay, excuse me.
So, just to wrap up.
We were talking about NSAIDs,
non-steroidal anti-inflammatories.
Aleve, Advil, ibuprofen,
a lot of people take them
for a lot of things,
just keep in mind,
they not only block
the inflammatory cascade
but they block a lot of things
that we really need
and blocking those can lead to issues
with your stomach,
issues with your kidneys,
issues with your heart
and some of those situations
are actually life threatening.
So, just really think
about possible alternatives
like turmeric and curcumin,
ginger, garlic, MSM
or other therapies
depending on your condition
that might help handle your issue,
your problem
and not put you at risk
for some of those life-threatening things.
I think that's good for today.
Alright, hope you enjoyed.
Any questions, comments,
please let me know.
You can write to us
and we'll handle it
and we'll answer them next time
and I hope you enjoyed it.
Again, Dr. Keller.
See you next time.
