Avoid pain killers and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen during training because they damage the gut and hinder absorption of nutrients, delaying recovery. NSAIDs have also been shown to impair healing of tendons and blunt muscle hypertrophy response.
A new study published in the journal Medicine and Science in Sports and Exercise tested what happens in the gastrointestinal tract during intense exercise after taking ibuprofen. Researchers measured a biomarker called IFABP, which when elevated, indicates damage to intestinal cells and is a marker of extended inflammation. IFABP was tested in trained cyclists at rest with ibuprofen, and after intense cycling with and without ibuprofen (400 mg of ibuprofen was taken about 12 hours before exercise and another 400 mg was taken an hour before exercise).
Results showed acute significant damage to the cells in the intestines as measured by IFABP after exercise with ibuprofen. Levels of IFABP following the cycling trial with ibuprofen was almost double that following the cycling trial without the drug (875 vs. 474 pg/mL). Simply taking ibuprofen and performing no exercise elevated IFABP to 507 pg/mL, indicating that taking NSAIDs alone causes inflammation, which is significantly increased with intense exercise In addition, following exercise with ibuprofen, other markers indicated that the barrier of the gut was injured, essentially causing leaky gut syndrome.
Researchers believe that when you combine intense physical activity with NSAIDs, damage to the intestines is increased as a result of redistribution of blood flow from the gut to the muscles, skin, heart, and lungs. This harms the lining of the gut, which could put you at risk for greater susceptibility to toxins because the gut lining is more permeable and not as protective. It will also inhibit absorption of nutrients, and long-term NSAID use could lead to serious damage to the gut and chronic inflammation.
Take away the understanding that you should avoid ibuprofen and NSAIDs when exercising because they can cause damage to the gut, put you at risk of infection, and impair nutrient absorption. NSAID use with exercise has also been associated with increased risk of cardiovascular adverse events, and they have been shown to get in the way of long-term tendon and muscle repair. NSAIDs reduce the regeneration of satellite cells, which are the cells that rebuild connective tissue that joins muscle with bone. NSAIDs also impair the muscle hypertrophy response by 50 to 75 percent in animals, and we know they suppress protein synthesis following a single bout of exercise.
Wijck, K., Lenaerts, K., et al. Aggravation of Exercise-Induced Intestinal Injury by Ibuprofen in Athletes. Medicine and Science in Sports and Exercise. 2012. Published Ahead of Print.