- March 28, 2004 at 4:19 am #1348
After finishing my post on “Boston and Trouble” figured I better clarify my statement about “Orally taken NSAIDs are not benign drugs in endurance athletes.” Like any medication when used appropriately they are useful and reasonably safe. NSAIDs work by inhibiting the production of “bad” inflammatory mediators called prostaglandins. Less prostaglandins=less swelling and less pain. Drawback is that there are some “good” prostaglandins esp in the kidneys and stomach. Whenever you take NSAIDs there is some GI toxicity (yes even with Vioxx, Celebrex, or Bextra) and alteration in renal perfusion.
Endurance sports, by their very nature, have a propensity to induce transient stomach and renal dysfunction (?who hasnt had the really bad stomach after a hot hard marathon or once in their carrer some blood in the urine following a brutal marathon). Consequently the combination of NSAIDs and marathoning is a really bad idea. Yea, the day after not unreasonable to take some advil or what have you to decrease soreness but please dont ever take advil or aleve before a long traning run or a marathon. Also if you have an injury that lingers such that you cannot train w/o taking daily NSAIDs that is a problem and its time to seek a cause that can be cured.
Hope this helps
- March 28, 2004 at 2:29 pm #13964
Evets, this is something I frequently caution people about. Occasional use is one thing but taking these things before running to me seems to be a very bad idea and I have heard about the problems of continued use. Definitely doesn’t sound like a good thing. I’m glad you addressed this, as hopefully your words, as a medical professional, will carry a little more weight with some people than mine do.
There was one thing in your post that I am interested in exploring a bit further. You mentioned blood in the urine. The father of one of my neighbors always seems to be over at my neighbor’s. Whenever he sees me going out for a run or coming back, the same conversation happens. He asks me if I’ve ever noticed blood in my urine. I tell him no. He says well, it’s there if you’ve noticed it or not. Then, he tells me about his story from when he was in the military and, every time he would run, he would have blood in his urine. He acts as though running is the least healthy thing I could be doing and I’m going to ruin my kidneys and bladder. I always blow it off, thinking it’s a heck of a lot healthier than being an obese smoker. Thoughts? Are his comments something I should take a bit more seriously or is this just the chicken little phenomenon.
- March 28, 2004 at 4:24 pm #13965
Blood in the urine (hematuria) is never normal but under some conditions is not unexpected and not the sign of a crisis. In a nonexercising individual blood in the urine is a sign of pathology and should be investigated as possible causes include kidney stone, infection, or kidney cancer. In the endurance athlete, however, some blood in the urine is frequently seen after a major episode of exertion. The mechanism is postulated to be either (1)watershed ischemia or (2)hydrostatic alterations in the glomerulus with transient renal leak. In any given person both may be involved. With watershed ischemia the person is exercising so vigorously that some cardiac output is shunted away from the kidneys producing some minimal ischemia and hematuria. The kicker with NSAIDs is that they also chemically diminish renal prefusion. Consequntly massive exercise resulting in watershed ischemia + NSAIDs can result in severe renal damage or even renal failure. Thus people should never ever take NSAIDs before a major race. After you have finished and adequately hydrated then OK to take an appropriate dose. There is no evidence that endurance sports alone (w/o NSAIDs or some other significant preexisting process) results in chronic kidney problems or leads to kidney disease! 😆 Have fun in St Louis, wish I could go watch but I’ll follow here!
- March 28, 2004 at 8:37 pm #13966
“Running causes blood in the urine, it’s happening to you whether you realize it or not” stated in a tone of warning is nothing but a chicken little claim or, at best, an uneducated person trying to take a piece of fact and stretch it. Good to hear that from someone who should know, although I basically already suspected that.
- March 29, 2004 at 1:58 pm #13967
Hey probably a good idea to bring this up here. I was doing tris last year and there were people (including me) that didn’t know the negative effects of NSAIDs and dehydration. Some of the guys were doing Ironman events in brutally hot conditions and taking NSAIDs. They were shocked when someone told them they were flirting with kidney failure.
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